Displaying 1 - 3 of 3
Contract Number Brand Code Brand Name Package Size Formulary Category Unit Price Strength Max. Reimbursable / Month Drug Contract Start Date Drug Contract End Date Restrict To Ophthalmologist Restrict To Pulmonologist Status Description Max Repeats
40 16814 STEMETIL 5MG TAB (SFA/COL) PROCHLORPER 25'S C 0.51 5MG 0 2022-04-01 2024-03-31 0
40 16819 CARMETIC 5MG TAB (CAR/COL) PROCHLORPERAZINE 1000'S A 0.07 5MG 180 2022-04-01 2024-03-31 6
41 16819 CARMETIC 5MG TAB (CAR) PROCHLORPERAZINE 1000'S A 0.0718 5MG 180 2024-04-01 2026-03-31 6